Association between high temperature and mortality in metropolitan areas of four cities in various climatic zones in China: a time-series study

作者：Yonghong Li, Yibin Cheng, Guoquan Cui, Chaoqiong Peng, Yan Xu, Yulin Wang, Yingchun Liu, Jingyi Liu, Chengcheng Li, Wu Zhen, Peng Bi, Yinlong Jin · 发表于：Environmental Health · 年份：2014 · DOI：10.1186/1476-069x-13-65 · 被引用次数：73 · 研究领域：Climate Change and Health Impacts、Thermal Regulation in Medicine、Climate variability and models

BACKGROUND: Numerous studies have reported on the associations between ambient temperatures and mortality. However, few multi-city studies have been conducted in developing countries including China. This study aimed to examine the association between high temperature and mortality outcomes in four cities with different climatic characteristics in China to identify the most vulnerable population, detect the threshold temperatures, and provide scientific evidence for public health policy implementations to respond to challenges from extreme heat. METHODS: A semi-parametric generalized additive model (GAM) with a Poisson distribution was used to analyze the impacts of the daily maximum temperature over the threshold on mortality after controlling for covariates including time trends, day of the week (DOW), humidity, daily temperature range, and outdoor air pollution. RESULTS: The temperature thresholds for all-cause mortality were 29°C, 35°C, 33°C and 34°C for Harbin, Nanjing, Shenzhen and Chongqing, respectively. After adjusting for potential confounders including air pollution, strong associations between daily maximum temperature and daily mortality from all-cause, cardiovascular, endocrine and metabolic outcomes, and particularly diabetes, were observed in different geographical cities, with increases of 3.2-5.5%, 4.6-7.5% and 12.5-31.9% (with 14.7-29.2% in diabetes), respectively, with each 1°C increment in the daily maximum temperature over the threshold. A stronger tempe...